CHAPTER
27
The Reproductive
System
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-2
Learning Outcomes
27.1 List the organs of the male reproductive
system and give the locations, structures,
and functions of each.
27.2 Describe how sperm cells are formed.
27.3 Describe the substances found in semen.
27.4 Describe the process of erection and
ejaculation.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-3
Learning Outcomes (cont.)
27.5 List the actions of testosterone.
27.6 Describe the causes, signs and symptoms,
and treatment of various disorders of the
male reproductive system.
27.7 List the organs of the female reproductive
system and give the locations, structures,
and functions of each.
27.8 Explain how ova develop.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-4
Learning Outcomes (cont.)
27.9
List the actions of estrogen and
progesterone.
27.10 Explain how and when ovulation occurs.
27.11 Describe what happens to an ovum after
ovulation occurs.
27.12 List the purpose and events of the
menstrual cycle.
27.13 Define menopause and explain what
causes it.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-5
Learning Outcomes (cont.)
27.14
Describe the causes, signs and symptoms,
and treatments of various disorders of the
female reproductive system.
27.15
Explain how and where fertilization occurs.
27.16
Describe the process of implantation.
27.17
Explain the difference between an embryo
and a fetus.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-6
Learning Outcomes (cont.)
27.18
Describe the changes that occur in a
woman during pregnancy.
27.19
List several birth control methods and
explain why they are effective.
27.20
List the causes of and treatments for
infertility.
27.21
Describe the causes, signs and symptoms,
and treatments of the most common
sexually transmitted diseases.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-7
Introduction
• Male and female reproductive systems
– Function together to produce offspring
– Female reproductive system nurtures
developing offspring
– Produce important hormones
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-8
Male Reproductive System
•
Testes
– Primary organs
• Develop in the abdominal
pelvic cavity of fetus
• Scrotum – sac that holds
the testes
• Seminiferous tubules
– On top of testes
• Descend into scrotal sac
shortly before or after birth
– Filled with spermatogenic
cells that produce sperm
cells
– Produce the male sex cells
(sperm)
– Produce the male hormone
testosterone
•
Interstitial cells produce
testosterone
Male
System
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-10
Spermatogenesis
Spermatogenesis
Spermatogonia (46 chromosomes)
Mitosis – makes primary spermatocytes
Undergo meiosis  two secondary spermatocytes
Divides – two spermatids = 4 spermatids
Develop flagella to become mature sperm cells
with 23 chromosomes
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-11
Sperm Cells
• Head
– Nucleus with 23
chromosomes
– Acrosome – enzymefilled sac
• Tail
– Flagellum that propels
sperm forward
• Helps sperm penetrate
ovum
• Midpiece
– Mitochrondria that
generate cell’s energy
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-13
Male Internal Accessory Organs
• Epididymis
– Sits on top of each testis
– Receives spermatids from
seminiferous tubules
– Spermatids become
sperm cells
• Vas deferens
– Tube connected to
epididymis
– Carries sperm cells to
urethra
• Seminal vesicle
– Secrete
• Fluid rich in sugar used to
make energy
• Prostaglandins –
stimulate muscular
contractions in female to
propel sperm forward
– Seminal fluid
• Released into vas
deferens just before
ejaculation
• 60% of semen volume
Male
System
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-14
Male Internal Accessory Organs (cont.)
• Prostate gland
– Surrounds urethra
– Produces and secretes a
milky, alkaline fluid into
urethra just before
ejaculation
– Fluid protects sperm in the
acidic environment of the
vagina
– 40% of semen
• Bulbourethral
(Cowper’s) glands
– Produce a mucus-like fluid
• Secreted just before
ejaculation
• Lubricates end of penis
• Semen
– Alkaline mixture
• Nutrients
• Prostoglandins
– 1.5 to 5.0 ml per ejaculate
– Sperm count of 40 to 250
million/mL
Male
System
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-15
Male External Accessory Organs
• Scrotum
– Holds testes away from
body
• Penis
– Shaft
• Erectile tissues surround
urethra
– Temperature 1° below
body temperature
– Glans penis
– Lined with serous
membrane that secrets
fluid
– Prepuce
• Testes move freely
• Cone-shaped structure on
end of penis
• Skin covering glans penis
in uncircumcised males
– Functions
• Deliver sperm
• Urination
Male
System
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-16
Erection, Orgasm, and Ejaculation
• Erection
– Parasympathetic nervous system stimulates erectile tissue
– Becomes engorged with blood
• Orgasm
– Sperm cells propelled out of testes into urethra
– Secretions from accessory organs also released into urethra
• Ejaculation
– Semen is forced out of urethra
– Sympathetic nerves then stimulate erectile tissue to release
blood
– Penis returns to flaccid state
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-17
Male Reproductive Hormones
• Hypothalamus
– Gonadotropin-releasing hormone (GnRH)
• Stimulates anterior pituitary to release
– Follicle-stimulating hormone (FSH) – initiates
spermatogenesis
– Luteinizing hormone (LH) – stimulates interstitial cells
in the testes to produce testosterone
– Testosterone
• Secondary sex characteristics
• Maturation of male reproductive organs
• Regulated by negative feedback
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-18
Apply Your Knowledge
Matching:
ANSWER:
D Vasectomy
___
A. Spermatogenesis
___
F Mixture of sperm and fluids
B. Testes
A Sperm cell formation
___
C. Penis
___
G Secrete alkaline fluid/prostaglandins
D. Vas deferens
B Produce testosterone
___
E. Hypothalamus
E GnRH
___
F. Semen
___
C Erectile tissue
G. Seminal vesicle
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-19
Diseases and Disorders of the Male
Reproductive System
Disease/Disorder
Description
Benign prostatic
hypertrophy (BPH)
Nonmalignant enlargement of the prostate gland;
common in older men
Epididymitis
Inflammation of an epididymis; usually starts as
an urinary tract infection
Impotence or erectile Disorder in which erection cannot be achieved or
dysfunction (ED)
maintained; about 50% of males between 40 and
70 have some degree of ED
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-20
Diseases and Disorders of the Male
Reproductive System
Disease/Disorder
Description
Prostate cancer
Most common form of cancer in men over 40;
risks of developing it increase with age
Prostatitis
Inflammation of the prostate gland; may be acute
or chronic
Testicular cancer
Malignant growth in one or both testicles; more
common in males 15–30 years; more aggressive
malignancy
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-21
Apply Your Knowledge
Your patient has an elevated PSA. What is a PSA
and what does it indicate?
ANSWER: The PSA is a prostate-specific antigen in
the blood. Elevations of the PSA may indicate prostate
cancer.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-22
Female Reproductive System
• Ovaries (2)
– Primary sex organs produce
• Sex cells called ova
• Hormones estrogen and progesterone
– Located in the pelvic cavity
– Medulla
• Inner area; contains nerves, lymphatic vessels, and blood
vessels
– Cortex
• Outer area; contains ovarian follicles
– Covered by epithelial and dense connective tissues
Female
System
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-24
Ovum Formation (cont.)
• Primordial follicles
develop before birth and
contain
– A primary oocyte or
immature ovum (born with
maximum number)
– Follicular cells
• Oogenesis is the process
of ovum formation
– At puberty, primary oocytes
are stimulated to continue
meiosis
• Becomes 1 polar body (a
nonfunctional cell) and
• A secondary oocyte
– Secondary oocyte released
during ovulation
– If fertilized, the oocyte
divides to form a mature,
fertilized ovum
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-25
Female Internal Accessory Organs
• Fallopian tube – oviduct
– Infundibulum and fimbriae
• Fringed, expanded end of fallopian tube near ovary
• Function to “catch” an ovum
– Muscular tube
• Lined with mucous membrane and cilia
• Propels ovum toward uterus
Internal Accessory
Organs
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-26
Female Internal Accessory Organs (cont.)
• Uterus
– Hollow, muscular
organ
– Receives embryo and
sustains its
development
– Divisions
• Fundus – domed upper
portion
• Body – main portion
• Cervix – narrow, lower
section extending into
vagina (cervical
orifice)
Internal Accessory
Organs
– Wall of uterus
• Endometrium
– Innermost lining
– Vascular
– Tubular glands –
mucus
• Myometrium
– Middle, thick,
muscular layer
• Perimetrium
– Thin layer covering
the myometrium
– Secretes serous fluid
to coat and protect
uterus
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-27
Female Internal Accessory Organs (cont.)
• Vagina
– Tubular, muscular organ
– Extends from uterus to outside body (vaginal
introitus)
– Muscular folds – rugae – enable expansion
• Receive erect penis
• Passage for delivery of offspring and uterine secretions
– Wall
• Innermost mucosal layer
• Middle muscular layer
• Outer fibrous layer
Internal Accessory
Organs
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-28
Internal Female Organs
Back
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-29
External Accessory Organs
• Mammary glands
– Secretion of milk
– Structures
• Nipple
– Oxytocin induces
lactiferous ducts to
deliver milk through
openings
• Areola – pigmented area
around nipple
• Alveolar glands – within
mammary glands
– Make milk when
stimulated by prolactin
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-30
External Genitalia
• Collectively known as the vulva
• Labia majora
– Rounded folds of adipose tissue and skin
– Protect other external reproductive organs
• Labia minora
–
–
–
–
Folds of skin between labia majora
Very vascular
Merge to form hood over clitoris
Vestibule – space enclosed by labia minora
• Bartholin’s glands secrete mucus during sexual
arousal
External
Genitalia
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-31
External Genitalia (cont.)
• Clitoris
– Anterior to urethral meatus
– Contains female erectile tissue
– Rich in sensory nerves
• Perineum
– Between vagina and anus
– Area for episiotomy, if needed, during birth
process
External
Genitalia
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-32
Erection, Lubrication, and Orgasm
• Nervous stimulation
– Clitoris becomes erect
– Bartholin’s glands activate – lubrication
– Vagina elongates
• Orgasm
– Sufficient stimulation of clitoris
– Walls of uterus and fallopian tubes contract to
propel sperm up tubes
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-33
Female Reproductive Hormones
Hypothalamus
secretes GnRH
GnRH
Anterior pituitary
releases FSH & LH
Estrogen and progesterone
Ovaries to produce
estrogen and
progesterone
 Responsible for development
of secondary sex characteristics
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-34
Reproductive Cycle
• Menstrual cycle
– Regular changes in uterine
lining, resulting in monthly
bleeding
• Menarche – first menstrual
period
• Menopause – termination of
cycle due to normal aging of
ovaries
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-35
Reproductive Cycle (cont.)
Anterior pituitary
releases FSH
Then releases
LH
Ovarian follicle
matures and secretes
estrogen
Triggers
ovulation
Follicular cells
become
corpus luteum,
which secretes
progesterone
Uterine lining thickens
Lining more vascular
and glandular
Without fertilization

Corpus luteum degenerates

Estrogen and progesterone
levels fall

Uterine lining breaks down
– menses starts

Cycle begins again with
release of FSH
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-36
YIPPEE!
Apply Your Knowledge
True or False:
ANSWER:
F The ovaries only produce estrogen.
___
produce estrogen and progesterone
F Ovulation is the process of ovum formation.
___
Oogenesis
T The fallopian tube is also called the oviduct.
___
F The endometrium is the outer layer of the uterine wall.
___
inner layer
T Alveolar glands produce milk.
___
F
___Oxytocin
induces the alveolar glands to deliver milk through the
nipples.
lactiferous ducts
___
F Menarche is the termination of the menstrual cycle.
first
T Menopause occurs due to normal aging of the ovaries.
___
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-37
Diseases and Disorders of the Female
Reproductive System
Disease/Disorder
Description
Breast cancer
Second leading cause of cancer deaths in
women; classified as stage 0 to 4
Cervical cancer
Slow to develop; Pap smear detects abnormal
cervical cells
Cervicitis
Inflammation of the cervix usually due to an
infection
Dysmenorrhea
Condition with severe menstrual cramps that limit
normal activities
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-38
Diseases and Disorders of the Female
Reproductive System (cont.)
Disease/Disorder
Description
Endometriosis
Tissues of uterine lining growing outside of the
uterus
Fibrocystic breast
disease
Abnormal cystic tissue in the breast; size varies
related to menstrual cycle; common in 60% of
women between 30 and 50
Fibroids
Benign tumors in the uterine wall; affect 25% of
women in their 30s and 40s
Ovarian cancer
Considered more deadly than other types;
detection difficult and often spreads before
detection
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-39
Diseases and Disorders of the Female
Reproductive System (cont.)
Disease/Disorder
Description
Premenstrual
syndrome (PMS)
Collection of symptoms occurring just before a
menstrual period
Vaginitis/
vulvovaginitis
Inflammation of the vagina/inflammation of
vagina and vulva; both associated with abnormal
vaginal discharge
Uterine (endometrial)
cancer
Most common in post-menopausal women;
causes about 6% of cancer deaths in women
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-40
Apply Your Knowledge
Matching:
ANSWER:
___
E Inflammation of the cervix
A. Dysmenorrhea
___
G Cancer common in post-menopausal women
B. Cervical cancer
___
B Develops slowly; detected by Pap smear
C. Fibroids
___
F Uterine tissue grows outside uterus
D. Breast cancer
___
D Second leading cause of cancer death in women E. Cervicitis
___
A Severe menstrual cramps
F. Endometriosis
___
C Benign tumors in the uterine wall
G. Uterine cancer
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-41
Pregnancy
• Pregnancy – condition of having a developing
offspring in the uterus
• Fertilization – process in which a sperm cell
unites with an ovum; results in pregnancy
– Only one sperm cell penetrates the follicular cells and
the zona pellucida that surround the ovum’s cell
membrane
– After fertilization, ovum releases enzymes that cause
the zona pellucida to become impenetrable to other
sperm
– Zygote forms from union of ovum and sperm
• Contains 46 chromosomes
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-42
The Prenatal Period
• Time before birth
• Zygote – undergoes rapid mitosis
– First week after fertilization
– Cleavage – rapid cell division
– Morula – ball of cells resulting from cleavage
• Travels down fallopian tube to uterus
• Becomes blastocyst, which implants in endometrial
wall
– Blastocyst
• Some cells (inner cell mass) become embryo
• Others, along with cells from uterus, form placenta
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-43
The Prenatal Period (cont.)
• Embryonic period
– Week 2 through 8
– Inner cell mass
organizes into
three primary
germ layers
• Ectoderm
• Mesoderm
• Endoderm
– Formation of
• Placenta
• Amnion
• Umbilical cord
• Yolk sack
• Most internal
organs and external
structures of
embryo
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-44
The Prenatal Period (cont.)
– Last 3 months – fetal
brain cells rapidly
divide
– GI and respiratory
systems last to
develop
• Fetal period
– Week 8 through birth
– Rapid growth
– 5th month – skeletal
muscles active
– 6th month – gains
weight
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-45
Fetal Circulation
• Placenta and umbilical blood vessels carry
out the exchange of nutrients, oxygen, and
waste products
• Unique differences from normal circulation
– Foramen ovale – hole between right and left
atria enables most of fetal blood to bypass
lungs
– Ductus arteriosus – connection between
pulmonary trunk and aorta
– Ductus venosus – vessel that bypasses liver
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-46
Hormonal Changes During Pregnancy
• Embryonic cells secrete human chorionic
gonadotropin (HCG)
– Maintains the corpus luteum
• Estrogen and progesterone
– Secreted by corpus luteum and placenta
– Functions
• Stimulate uterine lining to thicken, development of mammary
glands, enlargement of female reproductive organs
• Inhibit release of FSH and LH from anterior pituitary gland
(preventing ovulation) and uterine contractions
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-47
Hormonal Changes (cont.)
• Relaxin
– From corpus luteum
– Inhibits uterine
contractions and
relaxes ligaments of
pelvis
• Lactogen
– From placenta
– Stimulates
enlargements of
mammary glands
• Aldosterone
– From adrenal gland
– Increases sodium and
water retention
• Parathyroid
hormone (PTH)
– Helps maintain high
calcium levels in the
blood
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-48
Apply Your Knowledge
What are the primary germ layers and what tissue
develops from them?
ANSWER: The primary germ layers are the:
 Ectoderm – nervous tissue and some epithelial tissue
 Mesoderm – connective tissue and some epithelial tissue
 Endoderm – epithelial tissue only
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-49
The Birth Process
• Begins when progesterone levels fall
• Prostaglandins secreted by uterus stimulate
uterine contractions
• Uterine contractions stimulate posterior pituitary
gland to release oxytocin
• Oxytocin stimulates strong uterine contractions
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-50
The Birth Process (cont.)
• Three stages
– Dilation
• Cervix thins and softens (effacement)
• Lasts 8 – 24 hours
– Expulsion or parturition
• Actual birth
• May take 30 minutes or less
– Placental stage – 10 to 15 minutes after the
birth, the placenta separates from uterine wall
and is expelled
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-51
The Birth Process (cont.)
• The postnatal
period
– Six-week period
following birth
• Neonatal period –
first four weeks
• Neonate is
adjusting to life
outside uterus
• Milk production and
secretion
– Prolactin – production
of milk
– Oxytocin – ejection of
milk from mammary
gland ducts
– Production continues
as long as breastfeeding continues
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-52
Apply Your Knowledge
What are the three stages of the birth process and
what occurs during each?
ANSWER: The three stages are:
 Dilation – the cervix thins, softens (effacement), and dilates to
approximately 10 cm
 Expulsion – also called parturition; the actual birth stage
 Placental stage – placenta separates from uterine wall and is
expelled
Impressive!
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-53
Contraception
Method
Description
Coitus interruptus
Penis is withdrawn from vagina before ejaculation;
not a reliable method
Rhythm method
Requires abstinence around time of ovulation; not a
reliable method
Mechanical
barriers
Prevent sperm from entering female reproductive
tract
Chemical barriers
Destroy sperm in the female reproductive tract;
primarily spermicides; often used with mechanical
barriers
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-54
Contraception (cont.)
Method
Description
Oral
contraceptives
Birth control pills; prevent ovulation by preventing
LH surge
Injectable
contraceptives
Prevent ovulation and alter lining of uterus to
prevent implantation of blastocyst
Insertable
contraceptives
Ring inserted vaginally and removed at the
beginning of the 4th week to allow menstruation
Contraceptive
implants
Small rods of progesterone implanted beneath skin;
prevent ovulation
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-55
Contraception (cont.)
Method
Description
Transdermal
contraceptives
Contraceptives in the form of a patch; applied
weekly for 3 weeks; not used the 4th week to allow
menstruation
Intrauterine device Small, solid devices placed into uterus by MD;
(IUD)
prevents implantation of blastocyst
Surgical methods
Tubal ligation – fallopian tube fulgurated to prevent
sperm from reaching oocyte
Vasectomy – vas deferens is fulgurated to prevent
ejaculation of sperm
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-56
Apply Your Knowledge
Your patient has just been told that she is pregnant, but she
does not understand why she could get pregnant. She
states, “ I have been using the rhythm method of birth
control very carefully.” What patient teaching would you do
to assist her to understand?
ANSWER: The rhythm method is not as effective as other
birth control, because it is sometimes difficult to tell when
ovulation occurs.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-57
Infertility
• Inability to conceive a child
– Primary – no prior pregnancy, unable to
achieve pregnancy in 12 months
– Secondary – at least one prior pregnancy,
unable to achieve pregnancy after one year
– Causes
• 15% unknown
• 35% male-related problems
• 50% female-related problems
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-58
Infertility (cont.)
• Male-related
– Impotence
– Retrograde ejaculation
– Low or absent sperm
count
– Medications/drugs
– Decreased testosterone
– Scarring from STDs
– Prior mumps infection
– Inflammation of
epididymis or testes
• Female-related
– Scarring from STDs
– Pelvic inflammatory
disease
– Inadequate diet
– No ovulation or
menstrual cycle
– Endometriosis
– Abnormal shape of
uterus or cervix
– Hormonal imbalances
– Cysts in ovaries
– Older than 40 years
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-59
Infertility (cont.)
• Tests
– Semen analysis
– Monitoring of morning
body temperature
– Blood hormone
measurements
– Endometrial biopsy
– Urine analysis for LH
– Hysterosalpingogram
– Laparoscopy
• Treatments
– Surgical repair of
abnormalities
– Fertility drugs
– Hormone therapies
– Artificial insemination
– In vitro fertilization
– Use of surrogate
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-60
Apply Your Knowledge
Indicate whether each cause of infertility is male-related (M), female-related
(F), or both (B).
ANSWER:
M Retrograde ejaculation
___
M Mumps infection
___
F Inadequate diet
___
B Scarring from STDs
___
F
___
Pelvic inflammatory
disease
F
___
Hormone imbalances
M
___
Use of some medications
___
F
Being over 40 years old
Very good!
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-61
Sexually Transmitted Diseases
STD
Cause
AIDS
HIV virus causes AIDS; described in Chapter 21
Chlamydia
Caused by bacterium; most commonly reported;
often no symptoms in female
Genital warts
Caused by HPV; not everyone infected has
symptoms
Gonorrhea
Bacterial cause
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-62
Sexually Transmitted Diseases (cont.)
STD
Cause
Herpes simplex
Caused by viruses; type I causes cold sores; type II
commonly known as genital herpes; may be passed
from mother to child during childbirth
Pubic lice
Parasitic infestation; commonly called crabs
Syphilis
Caused by bacteria; decreasing in women but
increasing in males who have sex with other males
Trichomoniasis
Caused by protozoan parasite; also called
trichomonas infection or “trich”
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-63
Apply Your Knowledge
Match:
ANSWER:
D Most commonly reported STD in the U.S.
___
A.
F Two types; both caused by a virus
___
B.
E Crabs
___
C.
C Increasing incidence in males
___
D.
A Common bacterial STD; can also grow in mouth E.
___
B Caused by HPV virus
___
F.
S
Gonorrhea U
Genital warts P
Syphilis
E
Chlamydia R
Pubic lice
!
Herpes simplex
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-64
In Summary
27.1 The organs of the male reproductive system include
the testes, responsible for sperm and hormone
production, and the accessory organs of vas
deferens, seminal vesicles, prostate and
bulbourethral glands, scrotum, and penis.
27.2 Spermatogenesis begins in the seminiferous tubules
of the testes. They mature in the epididymis first as
spermatogonia, then as spermatocytes, and finally as
spermatids.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-65
In Summary (cont.)
27.3 Semen is a mixture of seminal fluid, prostatic fluid,
sperm cells, and lubricating bulbourethral fluid.
27.4 Erection occurs during sexual arousal, causing penile
engorgement with blood. Ejaculation occurs when
semen and its sperm cells are forced out of the body
through the urethra.
27.5 Testosterone is responsible for the male secondary
sex characteristics and maturation of the male
reproductive organs.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-66
In Summary (cont.)
27.6 The diseases of the male reproductive system vary
widely between simple inflammation and cancers.
The more common diseases and disorders, with their
varied symptoms and treatments, are outlined in the
Pathophysiology section of this chapter, immediately
following the A&P of the male reproductive system.
27.7 The organs of the female reproductive system include
the ovaries, fallopian tubes, uterus, and vagina. The
external accessory organs include the mons pubis,
labia majora and minora, clitoris, urethral meatus,
vaginal orifice, Bartholin’s glands, perineum, and
mammary glands.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-67
In Summary (cont.)
27.8 Ova originate from the primordial follicles within the
ovaries present during fetal development, which
produce the oocyte and follicular cells responsible for
oogenesis.
27.9 Estrogen is responsible for female secondary sex
characteristics. Both estrogen and progesterone
stimulate the uterine lining to thicken in preparation
for pregnancy and inhibit uterine contractions during
pregnancy.
27.10 Ovulation occurs when the anterior pituitary releases
a surge of LH, causing the release of a mature ovum.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-68
In Summary (cont.)
27.11 The follicular cells become the corpus luteum, which
releases more progesterone, which causes the
uterine lining to become more vascular and glandular
to prepare for the pregnancy.
27.12 The female menstrual cycle causes periodic changes
in the uterine lining. After a menstrual period, the
body prepares for the next ovulatory cycle with
increasing levels of estrogen and progesterone. If
pregnancy does not occur, these levels drop, causing
the uterine lining to break down and resulting in the
next menstrual period.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-69
In Summary (cont.)
27.13 Menopause is the cessation of the menstrual cycle
related to normal aging of the ovaries.
27.14 The diseases of the female reproductive system vary
widely between simple inflammation and cancers.
The more common diseases and disorders, with their
varied symptoms and treatments, are outlined in the
Pathophysiology section of this chapter, immediately
following the A&P of the female reproductive system.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-70
In Summary (cont.)
27.15 Fertilization occurs with the union of a sperm cell and
ovum; usually occurs within the fallopian tubes, but
may occur anywhere in the female reproductive tract.
27.16 The fertilized ovum, now a blastocyst, implants in the
endometrial wall of the uterus.
27.17 The embryonic period occurs from week 28 of the
pregnancy, and the fetal period is from week 9
through delivery.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-71
In Summary (cont.)
27.18 Hormonal changes stimulate the uterine lining and
inhibit FSH and LH production to prevent ovulation.
Mammary glands are stimulated and enlarged,
uterine contractions are inhibited, and the pelvic
ligaments loosen in preparation for delivery.
27.19 Some of the contraceptive methods include coitus
interruptus; barrier methods; chemical barriers; oral
contraceptives; injectable, implantable and insertable
contraceptives; and intrauterine devices. Their
mechanisms are discussed in detail within the
chapter.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-72
In Summary (cont.)
27.20 The causes of infertility are varied, with about 15% of
infertility for unknown causes. A number of infertility
tests and treatments are discussed within the
chapter.
27.21 There are many sexually transmitted diseases, all
passed between sexual partners (heterosexual and
same-sex partners alike). Their symptoms,
treatments, and sequelae for both sexes are
discussed in detail in the Pathophysiology section
devoted to STDs at the end of this chapter.
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.
27-73
End of Chapter 27
The reproduction of
mankind is a great marvel
and mystery.
~Martin Luther
© 2011 The McGraw-Hill Companies, Inc. All rights reserved.